tv 50th Anniversary of Medicare and Medicaid Summit CSPAN August 10, 2015 10:22pm-11:10pm EDT
artifacts and photography. then a look at the house ways & means committee. and finally, senate historian john richie talks about several historic hearings held in the russell senate office building including the truman committee investigation of world war ii expenditures and the 1954 army mccarthy hearings. that's tuesday night twbeginnin at 8:00 eastern here on c-span3. n now how a discussion on how president johnson succeeded in getting medicare passed. taking a look at the political process 50 years ago. speakers include lbj's lawyer linda johnson robb and his deputy special counsel larry levinson. hosted by the aspen institute, this is 50 minutes. >> our first panel today is called lbj and the battle to pass medicare and medicaid.
why johnson succeeded where others failed. we thought it would be important to look back at the complicated early history of medicare and how difficult it was for previous administrations to enact legislation that so many of us now take for granted. besides myself, our first panelists include linda johnson robb, the eldest daughter of president and mrs. johnson. linda is former chairman of st the board for "reading is fundamental" the nation's largest children's literary organization. and she serves on the board of the lbj foundation. she's also the former first lady of virginia, another proud alumnus of the university of texas in austin. her, i might mention, too, that her husband, former senator and former governor, chuck robb, is with us today. lynn ra diinda will be joined oy mr. levinson.
at the white house, larry helped shape and bring to enactment a comprehensive domestic legislative agenda which included medicare, the safe streets act, and landmark education and civil rights measures. he's a harvard law graduate and a lawyer in private practice today here in washington. and finally it's also my distinct pleasure to now introduce our first moderator, the great bob schieffer. as all of you know, bob is the cbs news chief washington correspondent and the award-winning host of "face the nation." bob made some news of his own earlier this month when he announced he was stepping down soon from "face the nation" and i'm hoping we will all help change his mind before lunch today. bob has been a reporter for more than half a century and has virtually won every award in
broadcast journalism during his august career including eight emmy awards. please give me a big round of applause for bob schieffer and our panelists. [ applause ] >> good to see you. >> let me pick this up for you. >> well, i want to tell you, i announced last week that i was going to retire after 46 years at cbs news, 58 years since i got my first job in journalism. i think i, for that reason, alone, i'm sort of an appropriate moderator to talk about how medicare got started. next week, i'm going down and signing up for part "b."
you know, when i announced i was going to retire last week, i'm 78 years old. that's 13 years past the retirement age for most people. i would not be here after surviving cancer, after living with diabetes, after surviviing ulcerative colitis where it not for the health care we get in the united states of america. i would just pose one question, what kind of a people would we be, what kind of a country would we be if we did not ensure that every single american has access to the same health care that i had and that got me to the point where at age 78 i can say i still feel good, i still feel like i can do the job, but i just want to quit while i can
still do the job. to me, what other argument needs to be made for the need to make health care available to all americans? and -- [ applause ] i thank you. it's so wonderful to mark this. the year s 1964 and 1965 were to of the most remarkable years in the history of america. you know, we remember presidents for their signature accomplishment many times. but when you think about those two years and the hundreds of significant pieces of legislation that were passed, including medicare, it's very difficult to look back on any presidency and think of that. just think about, we'd already come through 1964 and these days we all talk about, well,
nothing's going to happen this year because it's an election year. people forget that 1964 was an election year, and they passed the first of the two, well, lighter, that would be the fair housing act in 1968, but the three significant pieces of civil rights legislation, but that it was only one part of this enormous amount of legislation that was passed. in 1965, in addition to passing the medicare, the law creating medicare, you had the voting rights act, the national endowment for the arts was created. the national endowment for the humanities was created. the clean air act. the immigration act. and then, of course, the medicare and medicaid. it is not the first time, as we all know in this room, that people had tried, that presidents had tried to pass some sort of a medicare law.
fdr tried. he wasn't able to do it. harry truman had tried. he wasn't able to do it. but lyndon johnson managed to get it done. we want to start by showing you a few pictures of what it was like that day this legislation was signed. >> the harry s. truman library in independence, missouri, is a scene of an historic event, president and mrs. johnson and vice president humphrey arrive for ceremonies that will make the medicare bill a part of social security coverage. mr. johnson chose to sign the bill here as a tribute to former president truman. the former president campaigned for medicare 20 years ago, but it took two decades for his proposal to become law. the new law expands the 30-year-old social security program to provide hospital care, nursing home care, home nursing service, and outpatient
treatment for those over 65. medicare would become law on july 1st, 1966. and for mr. truman, and historic souvenir from the. president. for mr. truman the passage of medicare is a dream come true. >> there you are. what a remarkable day. and linda, i want to start with you. why was this such a priority with your father? >> well, daddy grew up in a world where he knew lots of people who had no choice of when they got older, they lost the farm. they used everything they had to pay for their medical care. and then finally their only choice was to go to the
poorhouse. and he'd also seen what this did to their families. not just people my age, but their children where they had to make a decision, do we -- do we pay for grandmama to get the medical care she needs, or do we say we have got to take care of our own children so they can go to college or they can stay in school? and it was devastating. we had a third of seniors were living in poverty. and he recognized there was a great need to do something about it, and he was an opportunist and he recognized when he came in after that historic election where we had, what, i don't know, 70 new democratic -- new
democratic members of congress. he knew this was the time to do it. and presumably there's a story about dirksen, and a lot of the stories about dad do were hypocriful, but they were so good. believe it or not, i was not there running the nation. that's what you have to understand. i did not write this medicare/medicaid law. but it seems that after the election, senator dirksen called him and congratulated him on winning this great election. he said, i need to have this operation but i want to wait and see if you are going to meet with -- with the leadership. and if you are, i will postpone
this. daddy presumingly said it is so wonderful that you and i can go and get that medical care paid for by the government. now, wouldn't it be great if we could make it possible for everybody to be able to do that? and locked him in right then. one of the things that tdaddy really believed in, two very important things, one, he was the opportunist and he knew when he could get something through and when he couldn't. and he recognized that compromise is not the enemy. and he was willing to make some of those compromises in order to be able to get the republicans and maybe more arch conservative-democrats to sign on. one of the, of course, great stories is our friend, congressman mills, just, oh, no, he wasn't ever going to let it out of his committee, but then when he saw those votes come in
and he knew that he could get it passed, then his mother would say he jumped on it like a duck on a june bug. he -- he wanted to do it. but it was those kinds of things that he recognized that this was something that was crucial for the country. both for seniors and for their families. so that you could build a stronger middle class. you didn't devastate everybody when mother and daddy got old and needed it. one of the other things i think you brought out so well, bob, is it wasn't just when grandmom had the stroke, although that was a very important thing. it was when you got to the age where it was so important that you got those regular checkups so that you discovered the cancer, so that you discovered the diabetes, so that you discovered those things. and in those days, you couldn't
afford to go and get that -- that checkup and so, therefore, you were going to have bigger bills. it was going to be worse. we weren't going to catch it. people like bob schieffer are going to live and be healthy at 78 instead of having those problems when they were 62. >> i think -- i mean, to me, that was one of the things that as a political reporter that i always appreciated most about lyndon johnson. you are absolutely right, lynda, he had, number one, this ability to know how much and how far he could take the country which is why he split the civil rights bill into two bills. he knew they couldn't swallow that much in one gulp so he divided it in two. he had this great news judgment. lbj would have been a great political reporter. he'd been a great reporter
because he could always figure out what the lead was. he kept those wire service machines going 24 hours a day in the oval office. he was the only -- the only president who did that and when something happened, he knew in the best sense of the word what could we get out of this? it was the same thing when the civil rights problems were happening down in selma and he called martin luther king in and said, he told him, find the worst place, where the worst things are happening, we'll get all those reporters and the cameras down there and he said that will give me the leverage i need to push this legislation through. larry, what was it -- why did he decide to go after medicare? he obviously made the speech. it was part of his inaugural address in 1965. >> what happened is this goes back to johnson and his relationship with fdr. and it also tells you the story of two very important people. as chairman conyers will note.
let me just mention them now for a moment. wilbur mills who was the -- we used to call him the one-man veto on the ways & means committee. if you could not move him, you would never see medicare today. and so the question was, what would move wilbur k. mills, by the way, who came from a small town in arkansas, rural arkansas, 7,500 folks in arkansas. how many would get wilbur to get off the dime and move by bill? the second problem i've got is i've got this cantankerous old guy from virginia, howard smith. he's on the rules committee. i can't get anything through rules committee. so how am i going to break this log jam? so lbj had a real daunting task in front of him, overarching all of this was the ama. the ama would send leaflets to every one of their doctors. you'd walk in as a patient. the first thing the doctor would say is i may not see you next
week because this socialized medicine bill and what am i going to do? the patient was sitting there quivering saying i can't see my doctor anymore. some of the senior citizens got together and said, you know, every time a patient walks into a doctor, let's give him something from the bible to quote back to the doctor, so in a moment of concern when the patient walked in trembling and the doctor presented him with socialized medicine, the patient would squeak out, in the bible, it is said that cash not be not off in time of old age, forget me not when my strength fails. that little thing pushed the doctors from red to blue and said, okay. a couple of things happened. had to get the ama pacified.
the elections of 1965 brought in a number of democrats. there were now almost 300. and wilbur k. mills from arkansas said, you know, i think i can get this bill through because i think it's going to pass. with 300 democrats. in the house. i got 68 members of the senate under a number of great senate leaders like harry byrd and others. and so the climate and that moment was right. the majority in the house. the pendulum had swung in favor of the bill. how how do i deal with old mr. smith? he'll boggle the bill down in rules. well, speaker mccormick came up with an ingenious solution, if you don't get the bill out of the rules committee in 21 days, it's gone. so what lbj did by the depth of his parliamentary knowledge, chairman conyers, as you know, is to move away the legal and
political obstacles to moving a bill through. remember, you got to introduce the bill first then you got have to hearings and it has to be marked up. and it has to come out of the committee. then it has to two to tgo to th. lbj by his mastery of the political machinery in the house was able to move and remove the obstacles. and just one final note on that thought just to end it, he wanted to put a signature around the medicare bill and he called it hr1 and s1. to show the priority of the bill. >> you know, love hearing these stories because, you know, we're so used to now that nobody that washington just doesn't seem to work anymore. and it doesn't. i mean, you know, but one of the reasons it doesn't is because johnson had had such an intimate knowledge of the senate.
he knew every member and not just the ones that were on his side. i always thought that one of his great strengths was he could not only explain to someone why they should be with him, but he could explain in ways they understand why it was not a good idea to be against him. and i -- i always remember the story that joe calofano who was one of the closest aides in these days told about, he said once frank church was on the foreign relations committee and a big critic of president johnson and he was always coming in and quoting walter lippman who was a leading columnist of the day. walter lippman says this and walter lippman says that. he said the nexts time you need a dam on the snake river, why won't you call walter lippman? and frank church came around on that particular issue what they
were -- >> what he also did, this was the other part, is he knew what was important for that congre congressman, that senator in their ticket. >> absolutely. >> and he cared about it. he knew when he could horse trade and he respected the congress. and he knew that you had to treat them as important people. and insisted all of this staff and larry will tell you this that you answered the phone call of senator dirksen or a republican congressman same day as you did one for democratic congressman and democratic senators. and that was a very important thing to know their pain, to know what was important to them. and one time, you mentioned senator byrd, and having these virginia connections myself now, i know a lot about senator byrd,
senator byrd there was some vote coming up and nobody thought he would ever vote for this bill. and someone said, well, why did you vote for it? he said, well, he don't you vote for it? he said, well, when my niece died, it was cold and ice was around and senator john schumer was the only member who came to the funeral. and it was those personal relationships, too, and that -- and it was interesting, i cannot tell you enough good things about that congress. they also knew that this was a historic year. and they were willing to risk their political lives. last night, i had dinner with -- with governor sebaleus. and she said that her father was
elected in thatç '64 electric. he voted for medicare. he came from a town or his district in ohio that had never elected a democrat, at least not in her lifetime. and he voted for medicare. and he was voted out the next election. there were a lot of people like that. in virginia, there was a democratic -- only one member of the virginia delegation had voted for the voting rights act. and he was voted out the next year. there were a lot of courageous people in that congress who voted and changed this country. and made more of a difference in their one term there than a lot of people who were there forever and ever. and what we have to realize is that this bill did change the way we look at it.
and the way we live. as congressman connier said, it was a civil rights bill, too, in that it integrated our hospitals. i was looking back at some of the things that danny said. he talked about this letter from a woman in auburn, washington, and she wrote and she said i have never done anything as daring as riding to the top man of our wonderful country. but things are getting awful rough at our house now, so i'm hoping you can get medicare real soon. you see, my husband for almost 46 years -- chuck and i have been going on 48 now -- my husband of 46 years has had several strokes. we have both worked and bought land and were doing well when my husband became ill. now the bonds are gone.
i can't bond because we have no way to repay. we have very fine children, but both have families and homes to keep up, too, and we can't expect any financial aid from them. now, that's what we were talking about. what can we do for those people and how can we make it possible for them to get that help, that medical help, before they have those strokes sometimes? and it was a wonderful time to live. and we were lucky to do it. and we couldn't have done it without that compromise and the congress with the republicans and democrats both working together. and so the congress deserves a lot of credit. people like congressman conyers and former congressman dingle now. he just stepped down. but they were very active in getting this through when they
were young men. >> did you want to say something? >> yeah. i wanted to add one note to what linda said. it was an epic moment and you have to capture that moment and it took place sometime, i think, in march when the bill had gone up. hr-1 had gone up and nothing was happening. and lbj would every day come into the office and look at every committee schedule. he get on the phone to larry o'brien who was the chief of staff up on the hill and he said, larry, nothing is moving here. añ get something moving because there's nothing worse than a bill that sits and is not moving. it's like a dead cat on a porch in the summer. move the bill. and there came a time just within that very narrow framework when sitting in the ways and means committee room -- and if you've been up in the long worth building, it's still there in the back room.
billes and wilber cohen and the general counsel of hew then and who or three people sat down and what became law was done in about 15 minutes and mills got together and said, look, here is how we're going to do it. that's going to take care of the seniors. the republicans sitting across from me, you want to include the doctors? we're going to include supplemental doctor's care. and over there, medical lly incident gent. by the way, they named the hew building after wilber. few people in this country have ever heard of wilber collin. he was one of the great architects of medicare. and that bill was put together in about 15 minutes. three layer cake. medicare, medicaid, and the
doctors hospitalzation part b. and then they called lbj and said, mr. president, we've got it done and wilber began to explain it, wilber mills did. we pull this out, mr. president, and the first thing lbj said was i don't want any hippo kond ree access in that bill. and wilber collins said, you know, i knew you were going to ask that question. we're going to be able to control the costs and we're going to have the insurance companies in and don't you worry, mr. president, no hypocondriacs. >> and the power of the press, too. at the time, he was meeting with ama. they were really against it. and eddie said that now we've had this war going on and we need some doctors over in vietnam.
they're all well into. talk to your doctors and see if we can get them to rotate in and rotate out. the head of the ama said, oh, yes, mr. president, we're big patriots. >> so daddy said, well, call in the press. they all come in and the press said, well, what about medicare and medicaid? and daddy said, well, i've just had mr. such and such here and he has been a great patriot and he says that he is going to get these doctors to go in and help us in southeast asia. and we're going to help all these people. and he said, you know, they're willing to go in there and risk their lives. now, i'm sure that this is a law, that they're going to obey
the law. and the president said, oh, yes, mr. president came in. oh, of course we're going to obey the law. >> and that was the first endorsement of medicare by the american medical association. >> they're willing to risk their lives. i know that they'll do that. >> certainly they wouldn't deny health care to people in this country if they're willing to -- >> mark, linda talks about the war. it was going on. 1965 was -- was there a lot more than just this piece of legislation? just give us, as a historian, what was happening in 1965 and in the midst of it, he was able to pass this legislation. >> bob, the thing is, lbj knew the ephemeral nature of political capital. he earns the presidency in his own right in 1964 with the greatest landslide in election in american history at that
point. and he really sweeps into office along with two-thirds majority in both the house and senate. he realizes he has this moment to get through all this legislation that has been piling up for years and that no one had been able to a get through, including medicare and medicaid. lbj ultimately was a product of the new deal. he saw what government could do in leveling the playing field during the course of the new deal. and he saw his presidency as a means by which to finish the revolution that had begun by franklin roosevelt. as bob reenumerated, some remarkable things happened in 1965. lbj never, ever rested. in one year, you get not only medicare and medicaid, you get elementary and secondary education and higher education. an infusion of federal aid education for the first time in our history. you get the clean air act and the highway beautification act, which sounds cosmetic, but it is
remarkably transformative environmentally. you get the immigration act of 1965, which is the most sweeping immigration reform in the history of our nation and fundamentally changes the heart and soul of america. and you get voting rights. the most important civil rights legislation ever to go on the back without which you would not have barack obama as the 44th president of the united states. in addition to that, you get the establishment of the department of housing and urban development. you have the implementation of upward bound and head start. this is one single year. and i would argue that it is the most important year legislatively in the history of our country. probably even more so than the first year of franklin delanor roosevelt's new deal. linda mentioned that great encounter with the ama. and i might offer us context.
the ama, which larry mentioned, stood in the way of medicare for so long was 95% opposed to the implementation of medicare. and when those doctors came to the white house that day, the ama, they threatened to boycott to the tune of 95% of doctors refusing to do anything relating to medicare and medicaid. within two weeks of that meeting that linda mentioned where the president of the ama was put firmly on the spot, 95% of all doctors actually upheld medicare and medicaid. that was the power of lbj. but i'll mention one quick story if i may, bob. wilber mills, we talked about the very powerful chairman of the wayes and means committee to mark itself legendary and stood in the way of medicare like the ama for so long made the bill stronger. lbj had never seen this. and when someone came to him and
said, mr. president, chairman mills is actually strengthened the medicare bill, president johnson said, well, i'm going to get my brother. and they said why so, mr. president? he said there's an old joke about a fellow in my home city of johnson city, texas. and he was interviewing for a job as a switch operator on the railroads. and the fellow interviewing him said, well, what would happen if you saw two trains coming together and the threat of a collision was occurring? he said i'd get my brother. and the guy says, what do you mean? he said, well, my brother has never seen a train wreck before. and he said, i have never seen a bill get stronger after being in committee. >> i just want to make a comment about that picture with president truman. there was a big argument at the
white house. i had just been there for two weeks and the question was, well, do i sign the bill in the white house or do i go to the congress and sign it? all the advisers were saying, i don't want to take a trip anywhere. just do it here. have all the pens handed out. johnson said, no, no, i'm going to go down and see my old friend, president harry truman. suddenly, we all got galvanized. i got a call saying see if any of the roets velt friends are still around and if you can find one, send them down there and we'll work it out. we did find james roosevelt's grandson. if you look at the attendance list on that day showed up along with vice president humphrey. and when johnson came down there, everyone amrauted and truman was beaming. i just want you to hear this quote from harry truman as that torch passed from fdr to truman to johnson. here is what truman said. i'm glad you like the president.
i like him, too. he is one of the finest men i ever ran across. and then there was this big applause. lbj not only gave him a significant ceremonial pen, but he pulls out, he said, mr. president, here is your first medicare card. you don't have to fill out the form. if i may, the great thing about johnson, too, johnson understood how to get things done. but he also understood that you got things done often by giving credit away to the other guy. this is a great example of recognizing harry truman's heroic efforts to pass medicare and failing. and he goes down to independence. again, against the wishes of his advisers. and he signs it in harry truman's library and he says, you know, people didn't love harry truman for giving him hell. people loved harry truman for giving them hope. and johnson knew the importance of giving that credit away.
when the civil rights act of 1964 was signed, it was a bipartisan bill. we forget that today. it was absolutely necessary to garner the support of the northern republicans in order to get it through, it was fundamentally important. so he needed to enlist the support of his old pal, evrett dirkson who was the republican minority lead ner congress. and he calls up dirkson. he was from illinois. he said, you know, evrett, i was just in your home state of illinois, land of lincoln, and you're worthy of being in the land of lincoln, 200 years from today, people will only know two fellas from illinois. abraham lincoln and everett dirkson. sure enough, when he signed the civil rights law into law, he didn't give that first pen to ral abernathy or john lewis. he gave that first pen to
dirkson ensuring that he received proper credit for that bill. >> you know, i -- your sister told me that she once asked him, why did you give that pen to everett dirkson? and she told me, he replied, without him, we would have had a piece of legislation. with him, we had a law. >> absolutely. and he also said, you know, dr. king was already for this bill. he said everett dirkson had to -- he had to really talk him into it. and, you know, it's not just the south where you had strong civil rights objections. believe me, it was in cato, illinois. it was in lots of different places in the north and in the west. and they knew that that made the
difference. and he knew that you wanted to have those republicans just as you needed to have those republicans sign on for the medicare and medicaid because they're going to go back to their districts. and you want to make sure that those states sign up for that medicaid. and that those governors do what they're supposed to do with that. >> i always enjoy and i've known a lot of the people that work for her dad and i always asked this question, what was it like to work for him? >> do you want me to answer that question? >> yeah. >> i was at the pentagon and then i was assigned over to the white house. johnson always said, i've got a very first white house staff until you look around and you see all these people in the east wing and the west whipping. where do they come from? well, they weren't folks that he brought in from texas. these were folks that he got on the phone and said, i want two or three of the smartest folks
you've got over in hew. bring them over here. i want bob mcnamara. send over one or two of your guys. i want my staff to be full of people who come from the government and understand how government works. and when you're at the white house, you only would know that at 11:00 at night when you got home and you turn on the television, the most magical thing that ever happened, i worked on that during the day and there it is on live television at 11:00 at night. what you did during the day for those ten hours that you were devoted to moving legislation through. just one last item on that legislation. i want everybody to remember it. when the democrats got that big majority, as mark said, the problem with the ways and means committee was always 15-10 and mills would sit there and gnarl and say, i'm not goth to go this bill through. lbj went to mccormick and said
there's some rule i read that said the more democrats that come in, you have to change the ways and means committee. you have to giggle it around so you'll be able to get that vote. mccormick said, i don't think i can do that. and about 24 hours later, a bus arrived from somerset, massachusetts, with 100 senior citizens who camped outside of mccormick's office and said, change the alignment. change the alignment. those are the small little stories that when you put them altogether, you really understand how that bill became law. by the way, it was the 89th congress and medicare was 89-97. six no, sir months, 97 bills. >> how, mark, did lyndon johnson amass this -- this encyclopedic knowledge of the congress? how it worked?